Abstract
Dengue fever is an acute mosquito-borne disease caused by the dengue virus (DENV). Based on antigenic variations in the envelope (E) protein, DENV is classified into four serotypes (DENV-1 to DENV-4), with DENV-2 being most frequently associated with severe disease. Given its high transmissibility, broad geographic distribution, and rapid viral evolution, there remains an urgent need for specific antiviral therapeutics against dengue. Traditional Chinese Medicine (TCM)-characterized by multi-target pharmacology activity, generally favorable safety profiles, and a low propensity for inducing resistance-represents a promising complementary strategy for dengue prevention and treatment. Historical TCM records on Tianxing fever, a condition exhibiting strong clinical parallels with modern dengue, provide valuable insights for selecting candidate herbs, extraction methods, and dosage strategies. This review systematically examines herbal agents documented in classical TCM texts for the treatment of Tianxing fever and synthesizes contemporary pharmacological research on TCM-derived compounds with anti-dengue activity. Furthermore, it outlines key future research directions for TCM-based dengue therapeutics, with the aim of guiding clinical practice and modern drug development.